1437143021 NPI number — RBK CO

Table of content: DEIRDRE PATRICK MORSE PH.D. (NPI 1578734372)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437143021 NPI number — RBK CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RBK CO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437143021
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3202 OBERLIN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LORAIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44053-2752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3202 OBERLIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LORAIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44053-2752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-282-4044
Provider Business Practice Location Address Fax Number:
440-282-6328
Provider Enumeration Date:
09/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KUBASAK
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
440-366-9670

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0645305 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3645768 . This is a "OTHER ID NUMBER" identifier . This identifiers is of the category "OTHER".




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